Loading...
13120150 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19846 BEEKMAN PL CONTRACTOR:BROTHERS HOME PERMIT NO:13120150 IMPROVEMENT OWNER'S NAME: ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL n ,-7 REPLACE 5(E)WINDOWS& 1 (E)SLIDING GLASS DOOR, License Class Lige l� LIKE FOR LIKE.ALL WINDOWS/DOORS SHALL MEET _fZEGRESS Contractor / Z C AND BE TEMPERED WHERE REQUIRED BY CODE I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the Valuation:$5700 performance of the work for which this permit is issued. Sq.Ft Floor Area: I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31630124 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS O IT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA LAST C ED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by: ate: granting of this permit. Additionally,the applicant understands and will corn with all non-point source regulations per the Cupertino Municipal Code, ion 918. e !-2 RE-ROOFS: n Signature Date /� ��( 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is vinstalled without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) HAZARDOUS MATERIALS DISCLOSURE 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section$25505(255,33,and 25534. I have and will maintain Worker's Compensation Insurance,as provided for by / /dl 7//3 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall ' not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 918. Signature Date CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 19846 beekman pl DATE: 12/19/2013 REVIEWED BY: melissa APN: 316 30 124 BP#: "VALUATION: $5,700 El *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: WORK replace 5 e windows & 1 e sliding lass door, like for like. all windows/doors shall meet egress and SCOPE be tempered where required by code ��• � � Xfech.Plan Check I I Plumb, flan Check Elec.flan Check Llech.Permit Fee: Plumb.Permit Pee: Lice. Permit Fee: Other;ilerch.Insp, Other Plumb Imp. Li Other Elec.Imp. Rlech, Insp,Fee: Plumb. Irish.Fee: Elec.Imp,Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7ff 11113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 6 # Window/Sliding Glass Door Supp/.PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $418.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. ®OT Q 0 his $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: E: i2dtninistrative Fee: Work Without Permit? ® Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Building or Structure 71,0vel Documentation Fees: Strong Motion Fee: IBSEISMICR $0.57 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 ' - $1.57 $418.00 n . z©TAL FEE $419.57 1 .„ Revised: 10/01/2013